---

NHS Resources

That is not my strict understanding of events, but I will happily write to the hon. Gentleman with full clarification, including the exchange of letters that I had with Sir Ian Kennedy when the matter was raised earlier. There was slight confusion about who wanted what and when. However, there is no doubt that the issue is important. We are cognisant of the fact that we want to get the balance right between burdening the service with ever more top-down targets, and ensuring that hospitals and PCTs on the ground take issues such as venous thromboembolism seriously. We are aware that the chief medical officer has flagged up the issue, and the Secretary of State and I take it seriously as well. The hon. Gentleman discussed what he described as rationing but I would describe as sensible commissioning. I hope that through the excellent world-class commissioning work that has been going on, he will see more and more that PCTs at local level are really gripping this important issue and are providing value for money for their taxpayers and also high-quality service for patients in their area. There are one or two other drivers of change in respect of value for money in the health service. Under the Gershon programme, we have made annual savings of around 3 per cent. for each of the past four years. In 2007-08, that meant a saving to the NHS of £7.8 billion. The comprehensive spending review requires the NHS to maintain that level of saving until at least 2011. Through the pharmaceutical price regulation scheme, we recently negotiated a significant saving in the annual bill for branded drug treatments. It will lead to a £350 million saving for the whole of the UK in 2009-10, with further annual savings of £550 million in each of the four years after that. Going back to what I said earlier, that of course will not improve our productivity at all. That is another reason why we must take crude productivity measures of the NHS with a pinch of salt. The hon. Gentleman is absolutely right that we are now entering a period, after the current spending review period post-2011, when budgets will increasingly come under pressure. Getting value for money for the taxpayer as well as the most effective clinical outcomes has never been more important. With local control, the right incentives and the information that local providers need to make decisions that are right for their communities, the NHS can continue to provide excellent value for money for the taxpayer and provide patients with a better, more responsive, more personalised service than before. I am grateful for all the contributions that the hon. Gentleman has made towards that end. Question put and agreed to.